Right Ventricular Hypertrophy and Palpitations

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Submitted by Dr T on April 9, 2013 – 10:46am

I have been suffering from missed beats for several years now and have ignored them to the best of my ability. However in the last year they seem to have got progressively worse and have changed with regards to their frequency. I seem to get more runs of extra beats in a row and on occasion during exercise my heart will seem to completely irregular for up to 10 minutes leaving me light headed. When this occurs it feels like my heart is beating irregularly but the will go into a regular fast rhythm where it is beating in a regular way but feels like each beat is not pumping properly. On the last occasion this happened I went to hospital where my ecg showed right ventricular hypertrophy with right bundle block and something to do with a high ST however the palpitaions had stopped by this point so were not recorded.. I have had an echo which was fine, stress test which was fine and will have an MRI. The doctor says I have nothing to worry about.1. Why would my irregularitys have got worst recently?2. Is Right ventricular hypertrophy and right bundle branch dangerous?3. When my heart seems to get stuck pumping in an erratic way could it be dangerous?4 Should I limit exercise?
Hi Dan,
While your heart function may be OK, (right ventricular hypertrophy) RVH and any recent change in your heart rhythm such as increased palpitations are not and your doctors should look  further for an explanation.
Re: RVH, if blood does not flow well from the heart to the lungs, extra stress can be placed on the right ventricle. This can lead to right ventricular hypertrophy.
If you have a normal lung function and no congenital heart defect (excluded by these tests), some of these these other causes should be considered:
Amyloid disease (a rare disease)
Re: palpitations, the most common cause later on in life is coronary artery disease, which appears to have been excluded with the tests you underwent.
Re: RBBB, it can be associated with hypertension, and of course specifically, pulmonary hypertension.
Thus, make sure you have normal lung function, and if not, why.
For amyloidosis, a urine test for poteinuria would be a simple first step.
Hope this helps,

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